Fátima Cristina Alves Branco-Barreiro

Tinnitus handicap inventory: adaptação cultural para o Português brasileiro

TEMA: o zumbido pode provocar muitos prejuizos na qualidade de vida dos pacientes. A avaliacao de quanto a qualidade de vida e prejudicada pelo zumbido pode ser util para o melhor conhecimento do paciente em relacao as limitacoes impostas por este sintoma, a programacao terapeutica e a verificacao da eficacia terapeutica, quando aplicado antes e apos o tratamento. OBJETIVO: adaptar culturalmente o Tinnitus Handicap Inventory (THI) para aplicacao na populacao brasileira e avaliar a sua reprodutibilidade. METODO: a adaptacao cultural do THI (Newman et al., 1996) seguiu as etapas indicadas por Guillemin et al. (1993), que incluem a traducao do idioma Ingles para o Portugues, adaptacao linguistica e revisao das equivalencias gramatical e idiomatica. Realizou-se, tambem, a avaliacao das reprodutibilidades inter e intra-pesquisadores deste questionario. Participaram 30 pacientes com zumbido, dos sexos feminino 19 (63,3%) ou masculino 11 (36,7%), com idade entre 39 e 79 anos (media 56,8 anos), encaminhados a partir de ambulatorio especifico em otoneurologia. RESULTADOS: o THI foi adaptado para ser aplicado na populacao brasileira, denominado THI Brasileiro. Nao houve diferenca estatisticamente significante quanto a reprodutibilidade inter-pesquisadores nos resultados obtidos a aplicacao da versao brasileira deste questionario, bem como da reprodutibilidade intra-pesquisadores. Verificou-se prejuizo da qualidade de vida em relacao aos aspectos emocionais, funcionais e/ou catastroficos em todos os pacientes avaliados. CONCLUSAO: o THI foi traduzido e adaptado culturalmente para ser aplicado na populacao brasileira, mostrando-se um instrumento confiavel para verificacao do prejuizo causado pelo zumbido na qualidade de vida.

Desempenho no Teste de Detecção de Intervalo Aleatório - Random Gap Detection Test (RGDT): estudo comparativo entre mulheres jovens e idosas

PURPOSE: To compare the performances of young and elderly women on the Random Gap Detection Test (RGDT). METHODS: Seventy two women were evaluated, distributed in two groups: Control Group (CG), composed by 48 young women (mean age = 23.8 years) with normal peripheral hearing, and Experimental Group (EG), composed by 24 elderly women (mean age = 66.8 years) with normal peripheral hearing or mild sensorineural hearing loss. Both groups were submitted to the RGDT for pure-tones, in the frequencies of 500, 1000, 2000 and 4000 Hz. RESULTS: All subjects from CG identified gaps up to 40 ms in all tested frequencies, with average gap of 12.2 ms among them. In the EG, it was observed that 20 out of the 24 subjects did not identify intervals up to 40 ms in one or more frequencies. Data analysis showed statistically significant differences between the performances of the groups (p<0001). CONCLUSIONS: Age increase was shown as an aggravating factor for performance on the RGDT. This test proved to be a valuable tool for the evaluation of aging effects on auditory temporal resolution ability.

Postural Control in Older Patients with Benign Paroxysmal Positional Vertigo

Objective. To evaluate the effectiveness of a canalith-repositioning procedure in postural control of older patients with idiopathic benign paroxysmal positional vertigo (BPPV). Study Design. Prospective clinical trial. Setting. A tertiary referral center. Methods. A 9-month follow-up survey with a prospective design was conducted among 33 older patients with BPPV. Patients underwent static posturography (Balance Rehabilitation Unit [BRU]) and were administered the Dizziness Handicap Inventory (DHI) before and after the maneuver. After the treatment, they were compared with 33 healthy older subjects. The posturography parameters were the limit of stability (LOS), the center of body-pressure area (COP), and the velocity of oscillation (VOS) under conditions of visual, somatosensory, and visual-vestibular conflict. Results. One canalith-repositioning procedure relieved most patients’ complaints (54.5%), and 100% were relieved with 1 to 3 maneuvers. Total DHI score and all subscales improved after treatment (P < .01). The LOS values pretreatment (mean [SD] 134.27 [55.32] cm2) and posttreatment (181.03 [47.79] cm2) were significantly different (P < .01). Comparative analysis of COP values showed a relevant statistical difference in 8 of 10 postmaneuver conditions (P < .01). The postmaneuver VOS showed a significant difference under 7 conflict conditions. There were no differences between the healthy older subjects and treated patients for all VOS values under all conditions and for COP values under 9 conditions. Conclusion. The canalith-repositioning procedure promotes remission of symptoms, an increase in LOS, and improvement in postural control under conditions of somatosensory and visual conflict and visual-vestibular interaction.

Body balance in elderly patients, 12 months after treatment for BPPV

UNLABELLED Benign Paroxysmal Positional Vertigo is highly prevalent in the elderly population, triggering major changes in body balance. OBJECTIVE To compare the results obtained from static posturography in the elderly before and after otoliths repositioning maneuvers and 12 months after treatment onset. DESIGN longitudinal, descriptive and analytical study. METHOD Elderly patients with clinical diagnosis of BPPV submitted to Balance Rehabilitation Unit static posturography in 10 sensory conditions at three time intervals: before and after the repositioning maneuver and12 months after the treatment RESULTS We studied 23 subjects with a mean age of 68.74 years. Posturography revealed that the stability limit was not significantly different when the three time intervals were compared (p = 0.405). The center of pressure (CoP) showed a significant change in condition 2 (stable surface and closed eyes), because after the repositioning maneuver, the CoP significantly differed vis-à-vis the results before and 12 months after the treatment (p = 0.003). The values of body velocity sway (BVS) were significantly different in six sensory conditions in these three time intervals. CONCLUSION 12 months after the treatment for BPPV, the static posturography showed balance abnormalities similar to those found before treatment.

Desempenho de escolares de 7 a 12 anos no teste Gaps-in-Noise

ABSTRACT Purpose: To investigate the performance of children with no hearing complaints with ages between 7 and 12 years on the Gaps-in--Noise (GIN) test. Methods: All children were submitted to otoscopy, pure tone audiometry, speech audiometry, acoustic immittance measures, and dichotic digits test. Only children who passed the previous audiological assessment carried out the GIN test (37 chil-dren – 20 who were enrolled in private schools, and 17 from public schools). As there was no difference between the performance of children from public and private schools, both groups were combined for the analysis. Results: The following average values were found for performance on the GIN test: 7-year-olds (5.65 ms), 8-year-olds (5.12 ms), 9-year-olds (4.87 ms), 10-year-olds (5.1 ms), and children over 11 years old (4.75 ms). Conclusion: The mean gap detection threshold in the right ear was 5 ms and in the left ear, 5.19 ms. No age, gender, or ear effects were found for gap detection thresholds assessed by the GIN test.

Ocorrência de queixas auditivas em escolares com e sem dificuldade de aprendizagem

Introducao: disturbios auditivos como zumbido, perda de audicao e hiperacusia podem comprometer o desenvolvimento da linguagem nas criancas. Objetivo: verificar a ocorrencia de queixas auditivas (zumbido, desconforto a sons e dificuldades auditivas) em criancas de sete a 10 anos e relacionar a presenca ou nao dessas queixas ao desempenho escolar. Metodo: 31 criancas com idade entre nove a 12 anos, com media etaria de 10,22 anos, de ambos os generos. Os pacientes foram submetidos a entrevistas fechadas, por meio da aplicacao de um questionario pre-estabelecido baseado no trabalho de Coelho (2006). De acordo com a avaliacao realizada pela coordenacao pedagogica da escola quanto as dificuldades escolares, as criancas foram divididas em dois grupos, Grupo controle –G1(n=14) e Grupo de estudo-G2 (n=17). A analise dos resultados utilizada foi descritiva. Resultado: do total de pacientes (n=31), 38,70% apresentaram zumbido; 29,03% desconforto a sons e 29,03 dificuldades auditivas. Entre os pacientes com queixa de zumbido, 33,33% eram do G1 1 e 66,67,% do Grupo 2. Entre os pacientes com desconforto a sons, 33,33,% apresentavam a queixa no G1 e 66,67%, no G2. Discussao: O estudo encontrou maior ocorrencia da queixa de zumbido e de desconforto a sons, em criancas com dificuldade escolar. Conclusao: 38,70% das criancas estudadas referiram percepcao de zumbido e 29,03% referiram desconforto a sons. As queixas de zumbido e desconforto a sons foram mais frequentes nas criancas com dificuldade escolar.